Cost Revenue Analysis Tool (CORE Plus)

Management Sciences for Health (MSH)

The purpose of the Cost Revenue Analysis Tool Plus (CORE Plus) is to help managers and planners estimate the costs of individual services and packages of services in primary health care facilities as well as total costs for the facilities. The cost estimates are based on norms and can be used to determine the funding needs for services and can be compared with actual costs to measure efficiency.

CORE Plus is a spreadsheet-based tool that can be used to help determine projected and actual costs of integrated primary health care services broken down by individual interventions. It is a bottom-up costing tool that allows the user to estimate a standard cost for each intervention, broken down by drugs, tests, medical supplies and staff. The standard costs are multiplied by the number of each type of interventions to build the total direct costs for a facility to which are allocated indirect costs.

The tool also allows users to estimate service utilization based on a catchment population and to compare it with actual service utilization. Costs can be easily compared for different numbers of patients and different service delivery models. A strength of the tool is to be able to predict the cost of different numbers of particular interventions, such as child survival, within the context of an integrated Primary Health Care system, and the impact of changes in those interventions on the cost of the system as a whole. The tool has been used in many countries, including South Africa, where it was used to estimate the total cost of primary health care package for the Ministry of Health.